Individual
GARTH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
79 SPINYTHORN RD, LEVITTOWN, PA 19056-2216
(215) 783-8014
Mailing address
79 SPINYTHORN RD, LEVITTOWN, PA 19056-2216
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ01474100
NJ
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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